Subsection 3. The Material of Melancholy

There is much disagreement between Avicenna and Galen about the material of melancholy. You may read about it in Cardan’s Contradictions, Valesius’s Controversies, Montanus, Prosper Calenus, Capivaccius, Bright and Ficino. They have devoted either whole treatises or extensive discussions to it in their various works on this subject.

What this humour is, where it comes from and how it is generated in the body have not been adequately discussed by Galen or any ancient writer, Iacchinus thinks; nor can recent writers agree. Montanus, in his consultations, holds melancholy to be either material or immaterial, and Arculanus agrees. Material melancholy is natural: it is one of the four humours already mentioned.

Immaterial melancholy is adventitious, acquired, excessive, unnatural or artificially produced. Hercules de Saxonia places it in the spirits alone and derives it from an imbalance of heat, cold, dryness or moisture that alters the brain and its functions without material substance. Paracelsus entirely rejects and mocks this division into four humours and temperaments, but our Galenists generally approve it and subscribe to Montanus’s opinion.

Material melancholy is either simple or mixed. It causes harm through its quantity or quality and varies according to where it settles—the brain, spleen, mesenteric veins, heart, womb or stomach. Or it differs according to the mixture of the natural humours with one another, or of the four unnatural, burnt humours, as these are blended in different proportions.

If natural melancholy, which is cold and dry, abounds in the body beyond what it can comfortably bear, the body must become disordered and diseased, says Faventinus. The other kind, if corrupted, produces similar effects, whether it arises from that other melancholy of burnt choler or from blood. As Montalto argues, if it comes from the burning of humours, it is usually hot and dry.

I find some disagreement about whether this melancholy substance can be generated from all four humours, and about its colour and temperament. Galen holds that it can be generated from only three, excluding phlegm. Valesius and Menardus firmly uphold his assertion as true, as do Fuchs, Montalto and Montanus. How, they ask, can white become black? But Hercules de Saxonia, in chapter 8 of his posthumous book on melancholy, and Cardan take the opposite side.

It can be generated from phlegm, though this rarely happens. Guianerius and Laurentius, chapter 1, agree, as does Melanchthon in the chapter on humours in his book On the Soul. He calls it asinine—dull, swinish melancholy—and says that he has seen it himself. Wecker takes the same view.

One kind arises from burnt black bile; another, the most brutish, from choler; another, dull in character, from phlegm; and the last, the best, from blood. Some are cold and dry, others hot and dry, varying with their mixtures as these are intensified or weakened.

Indeed, as Rodericus a Fonseca concludes in his twelfth consultation, ichors and watery fluids become phlegm when thickened; phlegm degenerates into choler, and burnt choler becomes verdigris-coloured melancholy. In the same way, pure wine becomes vinegar through decay or through the evaporation of its finer spirits, turning sour and sharp. From the sharpness of this humour come much sleeplessness, disturbing thoughts and dreams, and so forth.

So I conclude as before: if the humour is cold, Faventinus says, it causes mental derangement with milder symptoms; if hot, the sufferers are reckless, raving mad or inclined that way. If the brain is hot, the animal spirits are hot, and great madness follows, with violent actions; if cold, intellectual incapacity and dullness follow, according to Capivaccius.

The colour of this blend likewise varies with its mixture, whether hot or cold: sometimes it is black, sometimes not, says Altomarus. Melanelius proves the same from Galen and from Hippocrates’s book on melancholy—if it is indeed his—using the example of a burning coal: when hot, it shines; when cold, it looks black. So does the humour.

This variety of melancholy substance produces a variety of effects. If it remains inside the body without putrefying, it causes black jaundice; if it putrefies, a quartan fever. If it breaks out onto the skin, it causes leprosy; if into particular parts, various diseases such as scurvy. If it disturbs the mind, its different mixtures produce different kinds of madness and mental derangement. I shall discuss these in their proper place.